A influência de fatores socioculturais e clínicos sobre o perfil cognitivo de crianças e adolescentes sobreviventes de tumores de fossa posterior
Central Nervous System tumors are the most common pediatric solid neoplasms. The posterior fossa, notably the cerebellum, is the region with the highest incidence, where medulloblastomas and pilocytic astrocytomas are more frequent. Medulloblastomas are treated with neurosurgery (NC), systemic chemo...
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| מחברים אחרים: | |
| פורמט: | doctoralThesis |
| שפה: | pt_BR |
| יצא לאור: |
Universidade Federal do Rio Grande do Norte
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| נושאים: | |
| גישה מקוונת: | https://repositorio.ufrn.br/handle/123456789/45953 |
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| סיכום: | Central Nervous System tumors are the most common pediatric solid neoplasms. The posterior
fossa, notably the cerebellum, is the region with the highest incidence, where medulloblastomas
and pilocytic astrocytomas are more frequent. Medulloblastomas are treated with neurosurgery
(NC), systemic chemotherapy (QT) and cranio-spinal radiotherapy (RTX), while most
astrocytomas require NC only. The survival range is achieved through sequelae on the
development of survivors, especially associated with the neurotoxicity of anti-neoplastic
treatment, to which damage to the integrity of the white matter (SB) is attributed. Different
factors are added to this complex mosaic, with emphasis on sociocultural aspects, which,
independently or superimposed, dialectically structure the development processes. The present
work aimed to investigate the influence of sociocultural and clinical aspects on the cognitive
profile of children and adolescent survivors of Posterior Fossa Tumors (PFT). The research
was subdivided into three studies: 1) Influence of the maternal schooling on intellectual
capacity in pediatric PFT survivors; 2) Memory investigation in pediatric PFT survivors; 3)
Brain lesions in childhood: a case study of a malignant posterior fossa tumor. Thirty seven
subjects aged six to 16 years composed the clinical group and 25 subjects – participants in
study 2 only -, the control group, paired 1:1 according to sex, age, type of school, and
socioeconomic status of the participants in study 2. The Neuropsychological evaluation
performed with the participants and the data analyzed used descriptive and inferential statistical
tools. In study 1, we found that the type of treatment was significantly associated nonverbal
cognitive functions of intellectual ability, while the maternal schooling variable was associated
with impacts on verbal dimensions. In study 2, we found that the clinical group submitted only
to NC showed impairments, especially in the verbal working memory, while the broader
mnemic impacts were related to the group submitted to antineoplastic therapies. Lower
working memory performances were identified in children whose mothers had a lower level of
education. In study 3, the neuropsychological profile of the child medulloblastoma survivor
revealed relatively mild impairments considering the expected cognitive deficits for subjects
treated by antineoplastic therapies. The findings suggest that the sociocultural conditions that
permeated the child's development acted as protective factors against the emergence of more
serious cognitive sequelae. Thus, the expressive complexity underlying the manifestation of
the cognitive profiles presented by this population is highlighted and the central role of the
variable maternal education is revealed. |
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